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Perhaps the most hotly contested race for the U.S. House this year in Kentucky is in the 6th congressional district, which includes Lexington and the surrounding area. And for the six Democrats competing in Tuesday’s primary for the party’s nomination to challenge incumbent Republican Andy Barr, health care has become a central issue to their campaigns.

Over his three terms in Congress, Barr has voted dozens of times to repeal the Affordable Care Act, also known as Obamacare. Last year during a town hall, he fielded questions from constituents who were angry at his stance on repealing the ACA.

Barr is up for re-election this year, and is expected to win the Republican primary on Tuesday. And he’s one of many national Republicans expecting to face a Democratic challenger in November who either want to keep the ACA or go to a single payer health care system.

According to a Gallup poll earlier this year, 55 percent of Americans worried a “great deal” about their health care, including the availability and cost. It topped a list of 14 other issues the poll surveyed people on. Whoever 6th district Democrats choose on Tuesday could indicate which health care approach resonates the most — and which candidate’s ideas they feel have the best chance of beating Barr in November.

What Democrats Are Running On

In her campaign for the 6th district seat, Democrat Amy McGrath has estimated the many attempts to repeal and replace the ACA would have resulted in 23 million people losing health insurance.

McGrath supports what she calls a “public option.” This would mean the government would start its own plan that would be sold in the current individual market, alongside private insurers.

“A major reason for a public option — beyond the effect of generally lowering premiums since government would not be trying to make a profit — would be to guarantee that in those counties with just one or two insurers, rates could not be artificially spiked because of lack of competition,” McGrath wrote on her campaign website.

She’s also for expanding Medicare insurance – which currently offers basic health insurance for people age 65 and over – to anyone older than 55. This would give everyone, starting at age 55, the option to buy into Medicare coverage by paying a premium.

Meanwhile Lexington Mayor Jim Gray is running on a platform that includes keeping the Affordable Care Act as-is, but improving it.

“For the last six years, Andy Barr has worked to repeal and replace the Affordable Care Act,” Gray said during that debate. “It is time for us to focus on repealing and replacing Andy Barr.”

Another contender running in the Democratic primary Tuesday is Reggie Thomas, a current state senator. He’s running on overhauling the health system to what’s called “single payer.” This system would look similar to what Medicare already provides for people age 65 and up, but would include all ages.

“We can’t afford to continue the health care system we have,” Thomas said in an interview with host Matt Jones last year. “The single payer system that I envision would allow for freedom of choice, as it does now, but most people can’t go to a doctor without an insurance company say[ing] you can go here, you can’t go there.”

Thomas also condemned Barr on his campaign website for voting for repealing the Affordable Care Act.

“We have a congressman who time and time again has sided with insurance companies… and who has voted to kick over half a million Kentuckians off their health insurance,” Thomas wrote.